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GastroIntestinal (GI) > Liver Disease > Flashcards

Flashcards in Liver Disease Deck (32):
1

What does Cirrhosis of the liver cause?

Reduced Metabolic Capacity
Portal Hypertension
High Portal Pressure
Lower Albumen
Ascites
Shunting of blood

2

What are the three major symtpoms of liver failure?

Reduced blood flow to liver
Reduced Metabolic function
Reduced Plasma Proteins

3

What drugs are used to treat for ascites and liver failure?

Non-steroidal Anti-inflammatory (NSAID)
Paracetamol
Opiate

4

What is the caput medusa?

Engorged periumbilical veins.
Sign of liver disease

5

When taking a drug explain how the order of the reaction changes as saturation increases?

Metabolism starts off as first order - you metabolise at a constant rate (straight line)
Metabolise them becomes a zero order reaction.

6

In liver disease explain the plasma changes?

There is a low albumen therefore a low plasma volume

7

What secondary disease forms in

Secondary aldosteronism

8

What effect does liver disease have on hormones?

Increased Endothelin (VASOCONTRSCTOR)
Increased Oestrogen

9

What side effect is associated with endothelin?

Spider naevi

10

What effect does liver disease have on the kidney?

Potassium loss
Sodium retention
Water retention

11

What does the increased amounts of endothelin cause on the kidney?

Hepato-renal syndrome

12

What is the treatment for liver disease?

NSAID
Diuretic
Metoclopramide

13

What is the side effect of NSAID?

Hypertension

14

What in alcoholic's brain causes respiratory depression?

Sedative opiates

15

What effect does sedative opiates have on the body?

Brings about respiratory depression.

16

Describe the two mechanisms how drugs can be metabolised?

Phase I - Biotransformation (Fat soluble drugs)
Phase 2 - Conjugation (Glycoronidation)

17

For liver diseased patients what type of drugs should you try and choose?

Phase 2 Conjugation drugs

18

Describe how Paracetamol is metabolised?

Paracetamol is metabolised. This produces a highly reactive by product of N-acetyl-P-benzyoquinonimine
This is removed by Glutathione

19

What occurs in paracetamol toxicity?

N-acetly-p-benzoqinonimine levels build up.
Glutathione stores remove as much as they ca, however is all used up.
This causes N ace levels to cause damage to the liver.

20

What can induce hepatitis?

Anti-biotics ( Amoxicillin/ Flucloicillin)
Clavulanic acid

21

What is the best diuretic for liver disease?

Spironolactone

22

What drugs are used for sedation in liver disease?

Phase 2 metabolised benzodiazepines
- Lorazepam
-Oxazepam
- Lormetazepam

23

What are the worst hepatic disorders?

Fulminant Hepatic Failure
Decompensated Cirrhosis
Severe acute or chronic hepatitis
Severe Congestive Heart Failure

24

What is the main message for when administering drugs to a liver disease patient?

DOSE REDUCTION

25

What is Odynophagia?

Pain while swallowing

26

What is Haematemesis?

Blood in vomit

27

What is dyspepsia?

Patient comments of difficulty digesting

28

What is a side effect of jaundice?

Causes itching

29

If there is abdominal pain and jaundice what is a likely causes of the jaundice?

Obstruction

30

If there is no abdominal pain however jaundice what is the likely causes of the jaundice?

Cirrhosis

31

What is cirrhosis of the liver?

The liver is replaced by scar tissue. This gets worsened worse.

32

What are the different types of jaundice?

Pre-hepatic - infection
Intra- Hepatic - alcoholism
Post-hepatic - duct obsturction

then:
Conjugated
Unconjugated